Psychology Informed Consent Form

This Consent will provide you information about the study which will help you
understand what it is about and by which should help you decide whether or not you
would like to participate in the said study. The participation in this study is purely
voluntary. You may withdraw at any period through the duration of the study. The
withdrawal will not incur any penalty on the part of the participant.

This informed consent form aims to get the participant's consent for the evaluation on
car crashes and behaviour. Participants shall be viewing videos of car accidents and
answering a questionnaire. The initial participation in this study will take only around 15
minutes and information gathered will be anonymous and will be treated confidential.
Thus, no identity will be disclosed in the study, or even in any discussion that will take
place after.

In case further study is required, we will acquire from you additional consent for further
study which may last longer and may be continuing. Should you decide to withdraw
from the study at any point, you may freely do so and without penalty.

If in any case during the activity the participant feels uncomfortable answering the
questions and/or viewing the videos, they may withdraw from participating and the study
involving the participant will end. Upon completion of the activity, participants may ask
about the result and may ask questions freely.

In any case that you have questions regarding this study, please do get in touch with us
through our representative.

Participation in this activity is voluntary, either by direct act of the participant or through
solicitation. Participants may have an option to not write his/her name but this means
that in case that participant has follow-up questions concerning the results, we might not
be able to pull out or find the information relating to them.

By signing below I acknowledge that I understand the contents of this form and that I
have been sufficiently informed of the risks involved. I give my voluntary consent in
signing this form as my own free act and deed with full intention to be bound by the
same: free from any inducement or representation while taking full accountability.
Consent

❏ I am at least 18 years old and I give my consent to participation in this

activity.
❏ I am below 18 years old and my legal guardian consents to my
participation in this activity.

Name of Participant

First Name:

Middle Name:

Last Name:

Suffix:

Signature of Participant/Legal Guardian

Date Signed: